12.16.2019 Edition: Rise of the Digital Health Voice Assistants | The Healthy Muse

Blake Madden
6 min readDec 17, 2019


Top Weekly Healthcare Stories

M&A | Mednax

Starboard wants to sell Mednax

Starboard Value, a popular activist investment firm, wants Mednax to consider a company sale (WSJ paywall). Since Starboard owns a significant chunk of Mednax, they have a decent bit of power to try and make a sale happen.

It’s pretty clear why Starboard wants to pursue a sale strategy. If you had invested $100 in Mednax this year, you’d be down to $83. That’s AFTER this news broke, where the stock jumped 11% over the past 5 days.

Right now, the dialogue between Mednax and Starboard appears friendly, but things could turn ugly if Starboard doesn’t get what they want.

Digital Health | Innovation

Digital Assistant Notable Lands a Huge Deal with CommonSpirit, one of the Largest Health Systems in U.S.

Where’s Siri at, tho?

Digital health voice assistants not named Alexa are making headway into physician clinics. The latest assistant, named Notable, just inked a MAJOR deal with CommonSpirit Health, the newly merged nonprofit giant formerly known as Dignity and Catholic Health Initiatives.

The Big Picture.

The tech world seems to think that digital assistants, particularly voice-to-text capabilities for transcribing electronic health records, has a big future in healthcare.

  • With Alexa and the British NHS, Notable and CommonSpirit, and Suki with Ascension, it looks like the digital assistant land grab is just getting started.
  • Hopefully, the digital assistants lead to less administrative time and less physician burnout.

M&A | Managed Care

UnitedHealthcare buys Embattled Specialty Pharmacy, Diplomat for $300 Million

UnitedHealthcare’s 4-step guide to buying a specialty pharmacy:

  • Compete with the pharmacy
  • Undercut their business and disrupt their referral patterns
  • See their operations and stock price tumble

Trend Watch | Big Pharma

Cancer Drug Market Heats Up

Last week, I briefly touched on Merck’s acquisition of ArQule for $2.7 billion, but I missed Sanofi’s purchase for Synthorx for $2.5 billion. Side note: don’t you love the names of cancer drug developers?

The Bigger Picture.

As the oncology market reaches a projected $230 billion by 2024, other conditions and diseases, like psoriasis or multiple sclerosis, might be getting neglected.

There’s only so much time, money, and development resources available, after all. Drugmakers are making the easy business decision to go after a more lucrative market — possibly at the expense of other diseases.

Policy Corner, week of December 16th

Legislation | Surprise Billing

Providers Lose Out in Latest Bipartisan Surprise Billing Draft

Details of the Surprise Billing Bill.

The new bill is an altered version of older proposals. For bills under $750, insurers would pay providers the median in-network rates for that region.

Who Wants What.

Providers oppose the benchmarking part of the deal. They think the bill will lower reimbursement by giving them less room for negotiation (it will).

You should know: New York tried 3rd party arbitration to combat surprise billing in 2015. The catch? The bill guided arbitrators to use use the 80th percentile of billed charges as the starting point.

  • Here’s the problem with that: charges are generally made up numbers and do not correlate to actual reimbursement. Providers a certain amount for healthcare services but lower reimbursement from insurance/patients.
  • As a result, providers ended up receiving higher payments in New York.

If Congress pegs the arbitration to a high level of charges like New York did, insurers could lose out big time. But it’s important to note that the national bill is different because it includes benchmarked rates.


Keep in mind that this bill, while bipartisan, still has a long way to go — especially since a House panel just introduced a rival proposal. But these same solutions have been floating around Congress for a while now.

ACA | Supreme Court

SCOTUS Leaning Toward Insurers in Latest ACA Legal Battle

The ACA is back in the Supreme Court. This time, big insurance companies are accusing HHS of pulling a classic bait-and-switch.


The insurers claim that HHS promised to subsidize certain ACA plans if insurers entered that market. Unfortunately, Congress defunded this part of the ACA, and insurers weren’t paid. Cue insurance companies suing HHS for $12 billion.

Important: Remember to distinguish THIS case from the from the other ACA case, where the courts are assessing whether theACA is still constitutional after Congress dropped itsindividual mandate clause at the end of 2017, which previously had required everyone to have insurance coverage or face a fine.

CMS | Insanity

A White House Counseling Session

In what has been described as a “f******” soap opera (fill in the blank), White House officials have been mediating counseling sessions between HHS head Alex Azar and CMS head Seema Verma. Speaking of Ms. Verma, she’s had quite the week:

  • Ironic Timing: Modern Healthcare named Seema Verma healthcare’s #1 most influential person in 2019.
  • You should see yourself out: Joe Kennedy wants CMS Head Seema Verma to resign after reports surfaced that she had asked taxpayers to reimburse her for $47k related to stolen jewelry on a work trip. Charges were, of course, dropped for insufficient evidence.

From the WSJ, certain CMS employees are now accusing HHS of sexism. Quotes from the article:

Conclusion: I wouldn’t want to work there.

Policy | 2020 Election

Latest Healthcare Election News

From Politico: Andrew Yang’s six-step plan for healthcare. Hint: it doesn’t involve Medicare for All.

Drug Pricing: House Democrats passed Nancy Pelosi’s drug pricing bill. Even though it’s dead on arrival in the Senate, it shows how Democrats are thinking about drug pricing going into the 2020 election.

Vapers: Will the vaping demographic swing the 2020 election?

Divergence: Republicans and Democrats are far apart when it comes to healthcare. In my brief experience, healthcare views tend to get politicized pretty quickly, so this poll’s results make sense.

Quick Hits

Biz Hits

  • Cigna (WSJ): Is shopping its non-medical health insurance unit that could be valued at $6 billion.
  • Civica Rx: The nonprofit generic drug-maker for hospitals to cover shortages is expanding its drug lineup to 8 by the end of the year.
  • 3M is getting out of the drug delivery biz for $650 million
  • Lawyer Up: 23andMe is getting sued by a former business partner and fertility start-up Celmatix
  • Centene: Has been quietly lobbying to allow partial state Medicaid expansion.
  • Included in the Formulary: Express Scripts is adding new treatments to its recommended formulary to aid digital health innovation.
  • Home Health: The stories that shaped 2019.
  • Tenet: is exiting the Memphis market by selling two of its hospitals to Methodist Le Bonheur

State Hits

  • Kentucky’s Abortion Law: The Supreme Court declined from taking the Kentucky abortion ultrasound law.
  • In Texas: The extraordinary danger of being pregnant and uninsured.
  • Massachusetts: Blue Cross of Massachusetts is integrating its health plan with PillPack — Amazon’s online pharmacy service
  • To California: Planned Parenthood is opening up clinics LA high schools

Other Hits

  • Suicide Prevention: The FCC unanimously approved a new number for the Suicide Prevention Hotline: 988
  • An Inspiration: The champion behind the ALS Ice Bucket Challenge, Pete Frates, passed away December 9th.
  • Op-ed (WSJ): Former FDA head Scott Gottlieb thinks drug price controls will stifle innovation.
  • CRISPR: The startling secret of an invincible virus.
  • NFL Fraud: 10 former NFL players have been accused of defrauding the NFL’s healthcare program.
  • Millennials: Trust tech giants more than health systems.
  • Six CEOs and No Operating Room (WSJ): The Impossible Job of Fixing the Indian Health Service.
  • Health and Wellness: The definitive superfood ranking. The winner? Blueberries.

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Originally published at https://thehealthymuse.com on December 17, 2019.



Blake Madden

I write about healthcare. Policy, business, digital health, & more. Written in plain English. Here to connect, learn, and continue the healthcare convo.